Of 177 infants enrolled over 5 years, 83 were assigned to the LMA group and 94 to the intubation group. Overall, 65 patients (37%) experienced perioperative respiratory adverse events. Infants in the intubation group had a greater risk of adverse events than those in the LMA group (53% vs. 18%; relative risk [RR], 2.9). The intubation group had a higher risk of major adverse events (laryngospasm and bronchospasm; RR, 5.3) as well as minor adverse events (RR, 2.9), including desaturation <95% (RR, 7.1), persistent cough (RR, 3.0), stridor (RR, 1.8), and partial airway obstruction (RR, 1.6).
Comment:
As it is in adults, the LMA is a suitable alternative for airway management in infants when a definitive airway is not required or endotracheal intubation is not successful. Because endotracheal intubation provides a better seal, an LMA is not optimal for patients requiring high ventilator pressures to maintain adequate oxygenation and ventilation.